Please review the previous post with the case-presentation and image here, then proceed below

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The correct answer is A. The ‘teeth-like’ structures mentioned in the question and outlined in the picture above are ‘molar colonies’, created by the organism Actinomyces, which are usually branched, Gram positive rods that are present in the dentition as well as the GI/GU tracts of humans. They are known to create sinus tracts when infection occurs, and result classically in the formation of sulfur granules, which are clumps of organisms that are seen at the site of infection. Infection can involve the oral cavity, the GI tract, and in patients with IUD’s in place, pelvic inflammatory disease (PID) can occur. Although sulfur granules are the classic finding associate with Actinomyces, molar colonies can also be associated with this organism, and is worth remembering. None of the other options form these unique colonies. When an IUD is noted to have Actiomyces, removal of the device is usually sufficient in addressing the infection, especially if no symptoms concerning for PID are present. Success rates for removal of the IUD alone in such situations are 97.4%; in contrast, antibiotic treatment alone with agents such as doxycycline without IUD removal only has a success rate of 36.8%.

I hope you enjoyed this case, as always feel free to post any questions or comments below!

Reference:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2364307/